Provider Demographics
NPI:1720241177
Name:SPEEG, EMILY M (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:SPEEG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82283
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598-2283
Mailing Address - Country:US
Mailing Address - Phone:337-524-1700
Mailing Address - Fax:337-524-1702
Practice Address - Street 1:91 SETTLERS TRACE BLVD
Practice Address - Street 2:BLDG 3
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-524-1700
Practice Address - Fax:337-524-1702
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.203976207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology